Hagen, Bryan M

Hagen, Bryan M is an individual health care provider with primary practice located at 2955 N Highway 97 Ste 100 , Bend OR 97703-7559. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Psychiatric/Mental Health, Adult, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is his primary health care specialty. Hagen, Bryan M can be contacted via phone (541) 313-8501.

Contact Information

Primary practice address
2955 N Highway 97 Ste 100 Bend OR 97703-7559
Phone: (541) 313-8501
Fax: (541) 241-2363
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Psychiatric/Mental Health, Adult 163WP0809X 201042999RN Oregon
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 201250173NP Oregon

Profile Details

NPI number 1790872000
LBN Legal business name Hagen, Bryan M
Credentials DNP, PMHNP
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 6th, 2006
Last updated Sep 8th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790872000 NPPES
Oregon MEDICAID 500689745

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